Individual
MRS. SHANNON BECKER DOLEZAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, ATC, CSCS
Contact information
Practice address
3949 15TH AVE S, MINNEAPOLIS, MN 55407-2742
(706) 206-2639
Mailing address
3949 15TH AVE S # 55, MINNEAPOLIS, MN 55407-2742
(706) 206-2639
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
04/08/2006
Last updated
07/26/2021
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